Objective To evaluate the effects of periodontal intervention on inflammatory cytokines, adiponectin, insulin resistance (IR), and metabolic control and to investigate the relationship between type 2 diabetes mellitus (T2DM) and moderately poor glycemic control and chronic periodontitis. Methods and Patients A total of 190 moderately poorly controlled (HbA1c between 7.5% and 9.5%) T2DM patients with periodontitis were randomly divided into two groups according to whether they underwent periodontal intervention: T2DM-NT and T2DM-T group. The levels of serum adiponectin, C-reactive protein (CRP), tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), lipid profile, glucose, insulin, homeostasis model of assessment -insulin resistance (HOMA-IR) and homeostasis model assessment of β-cell function (HOMA-β) were measured at baseline and after 3 months. Results The levels of clinical periodontal variables, the probing depth, attachment loss, bleeding index, and plaque index were improved significantly in T2DM-T group after 3 months compared to T2DM-NT group (all p<0.01). After 3 months, the serum levels of hsCRP, TNF-α, IL-6, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS) and HOMA-IR index decreased, and adiponectin was significantly increased in T2DM-T group compared to those in the T2DM-NT group (p<0.05 or p<0.01). Conclusion Periodontal intervention can improve glycemic control, lipid profile and IR, reduce serum inflammatory cytokine levels and increase serum adiponectin levels in moderately poorly controlled T2DM patients.

Background:The development of platelet concentrated biomaterials has gained increasing awareness for regenerative medicine. With different protocol, derivatives such as advanced platelet-rich fibrin (A-PRF), injected platelet-rich fibrin, and concentrated growth factor (CGF) have been demonstrated effectively in preclinical and clinical studies. The aim of this study was to compare the level of growth factors releasing from A-PRF and CGF, and their clinical efficacy in the regenerative management of intrabony defects (IBDs).Methods: Thirty-two blood samples were collected from eight healthy donors and assessed for platelet-derived growth factor-, vascular endothelial growth factor, bone morphogenetic protein-2, and transforming growth factor-1 release at indicated times. In addition, the clinical records of 45 patients (15 per group) who had undergone guided tissue regeneration (GTR) with or without A-PRF/CGF were retrieved. The probing depth (PD) and clinical attachment level (CAL) were recorded preoperatively and 6 months postoperatively. Intrabony component (IC) depth, radiographic bone level (RBL), and bone defect filling were assessed radiographically. Results:A-PRF had a looser fibrin network than the CGF but presented larger amounts of growth factors with a more sustained release period. Although there was no difference in PD reduction, CAL gain, RBL height change and defect filling (%) between A-PRF and CGF group, both achieved a more favorable clinical result in IC height reduction and defect filling (%) than the control. Conclusions:A-PRF and CGF have the ability to stimulate a continual and steady release of total growth factors over a 14-day period. A-PRF and CGF show a similar effectiveness in periodontal bone regeneration with a potential benefit of improving GTR outcomes in IBD treatment. K E Y W O R D Sbone substitutes, growth factors, guided tissue regeneration, periodontitis, platelet-rich fibrin 462

Oral mesenchymal stem/progenitor cells (MSCs) are renowned in the field of tissue engineering/regeneration for their multilineage differentiation potential and easy acquisition. These cells encompass the periodontal ligament stem/progenitor cells (PDLSCs), the dental pulp stem/progenitor cells (DPSCs), the stem/progenitor cells from human exfoliated deciduous teeth (SHED), the gingival mesenchymal stem/progenitor cells (GMSCs), the stem/progenitor cells from the apical papilla (SCAP), the dental follicle stem/progenitor cells (DFSCs), the bone marrow mesenchymal stem/progenitor cells (BM-MSCs) from the alveolar bone proper, and the human periapical cyst-mesenchymal stem cells (hPCy-MSCs). Apart from their remarkable regenerative potential, oral MSCs possess the capacity to interact with an inflammatory microenvironment. Although inflammation might affect the properties of oral MSCs, they could inversely exert a multitude of immunological actions to the local inflammatory microenvironment. The present review discusses the current understanding about the immunomodulatory role of oral MSCs both in periodontitis and systemic diseases, their “double-edged sword” uniqueness in inflammatory regulation, their affection of the immune system, and the underlying mechanisms, involving oral MSC-derived extracellular vesicles.

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Background: Kikuchi-Fujimoto disease, known as histiocytic necrotizing lymphadenitis, is a benign, self-limiting and systemic disorder involving lymph nodes with unknown aetiology. First reported in Japan, there has been an increase in its incidence globally. Because of its non-specific clinical features, the disease can be easily mistaken for other forms of lymphadenitis with a high rate of misdiagnosis and mistreatment, posing a considerable challenge. Case presentation: A case of young Chinese woman with fever and cervical lymphadenopathy is presented. Physical examinations and imaging techniques were used to rule out common forms of lymphadenitis (e.g. cat-scratch disease and tuberculous lymphadenitis). Laboratory tests were then conducted to exclude others such as systemic lupus erythematosus and non-Hodgkin lymphoma. After Kikuchi-Fujimoto disease was identified, the patient was managed with symptomatic treatments. Our case was compared with relevant cases in the literature. A diagnostic flow chart was proposed to facilitate the diagnosis and treatment. Conclusions: With its shared clinical features, Kikuchi-Fujimoto disease can be mistaken for other forms of lymphadenitis. A combined use of medical imaging and laboratory tests is the effective way to avoid misdiagnosis.